Professional Documents
Culture Documents
forensic dentistry
Table 2 Features examined during the comparative dental identification. This extensive list
represents the complexity of these cases, particularly in those instances in which
restorative treatment is absent or minimal
Teeth Pulp chamber/root canal morphology Alveolar process and lamina dura
a. size, shape and number a. Height, contour, density of
Teeth present
b. Secondary dentine crestal bone
a. Erupted
b. Thickness of interradicular bone
b. Unerupted Pulp chamber/root canal pathology
c. Exostoses, tori
c. Impacted a. Pulp stones, dystrophic calcification d. Pattern of lamina dura
Missing teeth c. Root canal therapy e. Bone loss (horizontal/vertical)
a. Congenitally d. Retrofills f. Trabecular bone pattern and bone
b. Lost antemortem e. Apicectomy islands
c. Lost postmortem Periapical pathology g. Residual root fragments
Tooth type a. Abscess, granuloma or cysts
a. Permanent b. Cementomas
c. Condensing osteitis Anatomical features
b. Deciduous
c. Mixed Dental restorations Maxillary sinus
d. Retained primary 1. Metallic a. Size, shape, cysts
e. Supernumerary a. Non-full coverage b. Foreign bodies, fistula
b. Full coverage c. Relationship to teeth
Tooth position
a. Malposition 2. Non-metallic Anterior nasal spine
a. Non-full coverage a. Incisive canal (size, shape, cyst)
Crown morphology b. Laminates b. Median palatal suture
a. Size and shape c. Full coverage
b. Enamel thickness 3. Dental implants Mandibular canal
c. Contact points 4. Bridges a. Mental foramen
d. Racial variations 5. Partial and full removable prosthesis b. Diameter, anomalous
c. Relationship to adjacent
Crown pathology
structures
a. Caries
b. Attrition, abrasion, erosion Periodontal tissues Coronoid and condylar processes
c. Atypical variations, Gingival morphology and pathology a. Size and shape
enamel pearls, peg laterals etc. a. Contour, recession, focal/diffuse, b. Pathology
d. Dentigerous cyst enlargements, interproximal Temperomandibular joint
Root morphology craters a. Size, shape
a. Size b. Colour – inflammatory changes, b. Hypertrophy/atrophy
b. Shape physiological (racial) or pathological c. Ankylosis, fracture
c. Number pigmentations d. Arthritic changes
d. Divergence of roots c. Plaque and calculus deposits
Other pathologies
Root morphology Periodontal ligament morphology a. Developmental cysts
a. Dilaceration and pathology b. Salivary gland pathology
b. Root fracture a. Thickness c. Reactive/neoplastic
c. Hypercementosis b. Widening d. Metabolic bone disease
d. Root resorption c. Lateral periodontal cysts and e. Focal or diffuse radiopacities
e. Root hemisections similar f. Evidence of surgery
g. Trauma – wires, surgical pins etc.
a c
Antemortem panoramic radiograph
Fig. 3 Example of a comparative dental
identification case. The body depicted in the
images is that of a sixteen-year-old female.
She was found encased in a waterbed frame
after being reported missing for over a year. A
victim of homicide, she became mummified in
the dry, cool conditions under the bed. The
bed, used frequently, was removed when a
lodger left the apartment and the body was
discovered. Despite the condition of the soft
tissues the teeth remain in perfect condition.
The antemortem and postmortem
radiographs are shown below. A positive
identification, this case illustrates a non- d
restorative case. Note the mesiodens
Postmortem full-mouth radiographic survey
so-called non-restorative cases are likely to • Positive identification: The antemortem cient detail to render a positive conclu-
become more common.14 and postmortem data match in sufficient sion.16 The discretion of identification lies
Similarities and discrepancies should detail, with no unexplainable discrepan- with the odontologist who must be pre-
be noted during the comparison cies, to establish that they are from the pared to justify the conclusions in court,
process.15 There are two types of discrep- same individual. surely the ultimate in peer-review. Figure 3
ancy, those that can be explained and • Possible identification: the antemortem illustrates a case of dental identification.
those that cannot. Explainable discrepan- and postmortem data have consistent fea-
cies normally relate to the time elapsed tures but, because of the quality of either Postmortem dental profiling
between the antemortem and post- the postmortem remains or the ante- When antemortem dental records are
mortem records. Examples include teeth mortem evidence, it is not possible to unavailable and other methods of identifi-
establish identity positively.
extracted or restorations placed or cation are not possible, the forensic dentist
• Insufficient evidence: The available infor-
enlarged (ie MO amalgam that is now can assist in limiting the population pool to
mation is insufficient to form the basis for
MOD). Figure 2 illustrates explainable which the deceased is likely to belong and
a conclusion.
discrepancies. If a discrepancy is unex- • Exclusion: the antemortem and post- thus increase the likelihood of locating ante-
plainable, for example a tooth is not pre- mortem data are clearly inconsistent. mortem dental records.2 This process is
sent on the antemortem record but is known as postmortem dental profiling. The
present on the postmortem record then It is important to note that there is no information from this process will enable a
an exclusion must be made. minimum number of concordant points or more focused search for antemortem
A range of conclusions can be reached features that are required for a positive iden- records. A postmortem dental profile will
when reporting a dental identification. The tification. In many cases a single tooth can typically provide information on the
American Board of Forensic Odontology be used for identification if it contains suffi- deceased’s age, ancestry background, sex
recommends that these be limited to the fol- cient unique features. Equally, a full-mouth and socio-economic status. In some
lowing four conclusions:16 series of radiographs may not reveal suffi- instances it is possible to provide additional
or other establishment with a central steril- most forensic applications, (there are no authors have found that even root-filled
izing system for dental prostheses. Labelled nuclei, and hence there is no DNA, in red teeth supply sufficient biological material
dentures can be of great assistance in the blood cells.) When body tissues have for PCR analysis!48
identification of individuals.43 decomposed, the structures of the enamel, PCR-based analysis produces a DNA pro-
Unlabelled dentures have been recovered dentine and pulp complex persist. It is nec- file that can be compared with known ante-
from patients and then fitted to casts essary to extract the DNA from the calcified mortem samples or paternal DNA. Figure 8
retained by the treating dentist or labora- tissues. In the authors’ laboratory, the cryo- illustrates a case using DNA from teeth to
tory, and this has been an accepted method genic grinding method is employed determine the identity of found remains.
of identification.44 Other dental appliances, (Fig. 7).48 Teeth represent an excellent The identification of individuals is not the
such as removable orthodontic braces have source of genomic DNA. Indeed, the only use for dental DNA. The technique has
also been used for identification purposes.
Whittaker describes a case where a remov-
able orthodontic appliance was used to
identify a victim of a house fire.45 Authors
have also described the use of palatal rugae
patterns rendered on dental casts to com-
pare with found remains. Positive identifi-
cations have resulted from this technique.46
Dental materials have provided clues to
assist identification. One of the authors (DS)
has used SEM-EDX to identify the composi-
tion of a glass-ionomer restoration and then c
traced this back to a prison where the filling was
placed. Dental records secured the identifica-
tion of the individual. In another case, it was
possible to identify Kevlar fibers that had been
placed within a lower denture to reinforce it.
This rare procedure enabled an identification
of the wearer who was a victim of homicide.
Mitochondrial DNA
In addition to genomic DNA, cells contain
mitochondrial DNA (mtDNA), the
sequence of building blocks of which can
be determined to assist in identification.
The main advantage of mtDNA is that
there is a high copy number in each cell
caused by the high number of mitochon-
dria present in most cells. This infers that Teeth recovered from body (1999)
in cases where genomic DNA cannot be
Fig. 8 The use of DNA from teeth to
analyzed, possibly because it is too prove identity. Circumstantial evidence
degraded, mtDNA may be present in suffi- established the probable identity of a found
cient quantity. In addition to its higher human skull. Antemortem dental records
were not available for comparison.
copy number, mtDNA is maternally inher- Medical records revealed the availability of a
ited.50 This maternal inheritance pattern Pap (cervical) smear. Partial degradation of
confers the same mtDNA sequence, bar- DNA from teeth produced a profile at
ring mutations, upon siblings and all their eight genetic loci. These were compared
with the DNA profile obtained from the Pap
maternal relatives. This has important smear and established that the samples
implications for the identification of indi- originated from the same source
viduals for which there is no antemortem Pap smear (1992)
comparison sample. Although mitochon-
drial DNA is still in its infancy in forensic
casework, it is a powerful technique that is
likely to become commonplace in the
future.
Conclusions postmortem findings. In: Bowers C M Bell G, patterns of tooth wear with aetiological factors.
(eds). Manual of forensic odontology. 3rd ed. Br Dent J 1984; 157: 16-19.
Forensic dentistry plays a major role in the Ontario: Manticore, 1995. 37. Lochary M E, Lockhart P B, Williams W T.
identification of those individuals who 16. American Board of Forensic Odontology. Body Doxycycline and staining of permanent teeth.
cannot be identified visually or by other identification guidelines. J Am Dent Assoc 1994; Pediatr Infect Dis J 1998; 17: 429-431.
means. The unique nature of our dental 125: 1244-1254. 38. Livingston H M, Dellinger T M. Intrinsic
17. Steyn M, Iscan M Y. Sexual dimorphism in the staining of teeth secondary to tetracycline. Ann
anatomy and the placement of custom crania and mandibles of South African whites. Pharmacother 1998; 32: 607.
restorations ensure accuracy when the tech- Forensic Sci Int 1998; 98: 9-16. 39. Cuff M J, McQuade M J, Scheidt M J,
niques are correctly employed. In this brief 18. Burris B G, Harris E F. Identification of race Sutherland D E, Van Dyke T E. The presence of
overview, the authors have shown the reader and sex from palate dimensions. J Forensic Sci nicotine on root surfaces of periodontally
1998; 43: 959-963. diseased teeth in smokers. J Periodontol 1989;
some of the traditional and upcoming tech- 19. Hsu J W, Tsai P L, Hsiao T H et al. The effect of 60: 564-569.
niques in this fascinating field. shovel trait on Carabelli’s trait in Taiwan 40. Gupta B N. Occupational diseases of teeth.
Chinese and Aboriginal populations. J Forensic J Soc Occup Med 1990; 40: 149-152.
The authors gratefully acknowledge the suggestions of Sci 1997; 42: 802-806. 41. Maupome G, MacEntee M I. Prosthodontic
Dr David Kennedy of Vancouver, Canada with 20. Solheim T. A new method for dental age profiles relating to economic status, social
respect to the submission of this article to the British estimation in adults. Forensic Sci Int 1993; 59: network, and social support in an elderly
Dental Journal. Mr. Pretty is supported by a grant 137-147. population living independently in Canada.
from the Forensic Science Society (UK). 21. Shapiro H L. Forensic anthropology. Ann N Y J Prosthet Dent 1998; 80: 598-604.
Acad Sci 1978; 318: 3-9. 42. Borrman H I, DiZinno J A, Wasen J, Rene N.
1. Jones D G. Odontology often is final piece to 22. Noble H W. The estimation of age from the On denture marking. J Forensic Odontostomatol
grim puzzle. J Calif Dent Assoc 1998; 26: 650- dentition. J Forensic Sci Soc 1974; 14: 215-221. 1999; 17: 20-26
651. 23. Whittaker D K, Rawle L W. The effect of 43. Marella G L, Rossi P. An approach to
2. Sweet D, DiZinno J A. Personal identification conditions of putrefaction on species identification by means of dental prostheses in
through dental evidence-tooth fragments to determination in human and animal teeth. a burnt corpse. J Forensic Odontostomatol 1999;
DNA. J Calif Dent Assoc 1996; 24: 35-42. Forensic Sci Int 1987; 35: 209-212. 17: 16-19.
3. Weedn V W. Postmortem identifications of 24. Adachi H. Studies on sex determination using 44. Jacob R F, Shalla C L. Postmortem
remains. Clin Lab Med 1998; 18: 115-137. human dental pulp. II. Sex determination of identification of the edentulous deceased:
4. Whittaker D K, Richards B H, Jones M L. teeth left in a room. Nippon Hoigaku Zasshi denture tissue surface anatomy. J Forensic Sci
Orthodontic reconstruction in a victim of 1989; 43: 27-39. 1987; 32: 698-702
murder. Br J Orthod 1998; 25: 11-14. 25. Sweet D, Hildebrand D, Phillips D. 45. Whittaker D K. A Colour Atlas of Forensic
5. Rothwell B R, Haglund W, Morton T H. Dental Identification of a skeleton using DNA from Dentistry. Saint-Louis: Harcourt, 1989.
identification in serial homicides: the Green teeth and a PAP smear. J Forensic Sci 1999; 44: 46. Thomas C J, van Wyk C W. The palatal rugae in
River Murders. J Am Dent Assoc 1989; 119: 630-633. identification. J Forensic Odontostomatol 1988;
373-379. 26. Mincer H H, Harris F, Berryman H E. The 6: 21-27.
6. Andersen L, Juhl M, Solheim T, Borrman H. ABFO study of third-molar development and 47. Schwartz T R, Schwartz E A, Mieszerski L,
Odontological identification of fire victims- its use as an estimator of chronological age. J McNally L, Kobilinsky L. Characterization of
potentialities and limitations. Int J Legal Med Forensic Sci 1993; 38: 379-390. deoxyribonucleic acid (DNA) obtained from
1995; 107: 229-234. 27. Hongwei S, Jingtao J, Cameron J M. Age teeth subjected to various environmental
7. Dorion R B. Disasters big and small. J Can Dent determination of the molars. Med Sci Law conditions. J Forensic Sci 1991; 36: 979-990.
Assoc 1990; 56: 593-598. 1991; 31: 65-68. 48. Sweet D, Hildebrand D. Recovery of DNA from
8. Malkowski F S. Forensic dentistry, a study of 28. Ogino T, Ogino H, Nagy B. Application of human teeth by cryogenic grinding. J Forensic
personal identification. Dent Stud 1972; 51: aspartic acid racemization to forensic Sci 1998; 43: 1199-1202.
42-44. odontology: post mortem designation of age at 49. Sweet D J, Sweet C H. DNA analysis of dental
9. Brannon R B, Kessler H P. Problems in mass death. Forensic Sci Int 1985; 29: 259-267. pulp to link incinerated remains of homicide
disaster dental identification: a retrospective 29. Liversidge H M, Molleson T I. Developing victim to crime scene. J Forensic Sci 1995; 40:
review. J Forensic Sci 1999; 44: 123-127. permanent tooth length as an estimate of age. J 310-314.
10. Alexander C J, Foote G A. Radiology in forensic Forensic Sci 1999; 44: 917-920. 50. Hutchison C A, Newbold J E, Potter S S, Edgell
identification: the Mt. Erebus disaster. 30. Harley K. Tooth wear in the child and the M H. Maternal inheritance of mammalian
Australas Radiol 1998; 42: 321-326. youth. Br Dent J 1999; 186: 492-496. mitochondrial DNA. Nature 1980; 251: 536-538.
11. Chapenoire S, Schuliar Y, Corvisier J M. Rapid, 31. Murray M O, Wilson N H. Ecstasy related 51. Morlang W M. Dentistry’s vital role in disaster
efficient dental identification of 92% of 13 tooth wear. Br Dent J 1998; 185: 264. preparedness. J Calif Dent Assoc 1996; 24: 63-66.
train passengers carbonized during a collision 32. Bartlett D. Regurgitated acid as an explanation 52. Clark D H. The British experience in mass
with a petrol tanker. Am J Forensic Med Pathol for tooth wear [letter, comment]. Br Dent J disaster dental identification. United Kingdom
1998; 19: 352-355. 1998; 185: 210. disasters. A historical review. Acta Med Leg Soc
12. Clark D H. An analysis of the value of forensic 33. Nunn J, Shaw L, Smith A. Tooth wear-dental 1990; 40: 159-165.
odontology in ten mass disasters. Int Dent J erosion. Br Dent J 1996; 180: 349-352. 53. Morlang W M. Mass disaster management
1994; 44: 241-250. 34. Robb N D, Smith B G. Prevalence of update. CDAJ 1986; 14: 49-57.
13. Goldstein M, Sweet D J, Wood R E. A specimen pathological tooth wear in patients with 54. Pretty I A, Webb D A, Sweet D. The design and
positioning device for dental radiographic chronic alcoholism. Br Dent J 1990; 169: assessment of mock mass disasters for dental
identification. Image geometry considerations. 367-369. personnel. J Forensic Sci 2001; 46: 74-79.
J Forensic Sci 1998; 43: 185-189. 35. Milosevic A, Slade P D. The orodental status of 55. Woodward J D. Identification of victims
14. Murray J. Prevention of oral disease. Oxford: anorexics and bulimics. Br Dent J 1989; 167: following a mass disaster. Ky Dent J 1982; 34:
Oxford University Press, 1986. 66-70. 37-41.
15. Silverstein H. Comparison of antemortem and 36. Smith B G, Knight J K. A comparison of